title: Youth and young adults with spina bifida: their utilization of physician and hospital services.
abstract: OBJECTIVE
  To describe current patterns of health care utilization of youth and young adults who have spina bifida (SB) and provide evidence to guide the development of health care for this growing population.
  
  
  METHODS
  We conducted a secondary analysis of health services utilization data from the Canadian Institute for Health Information to determine the rates and patterns of health care utilization, because comprehensive health care has been recognized as critical to positive health outcomes.
  
  
  METHODS
  Participants were identified from 6 publicly funded children's treatment centers.
  
  
  METHODS
  Health records from youth (n=164; age range, 13.0-17.9y) and adults (n=120; age range, 23.0-32.9y) with SB contributed to this study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The rates of outpatient physician visits and hospital admissions for the youth and adult groups were calculated. The proportion with a "medical home" was also calculated.
  
  
  RESULTS
  The annual rates of outpatient physician visits per 1000 persons were 8031 for youth and 8524 for adults with SB. These rates were approximately 2.9 and 2.2 times higher, respectively, than for their age-matched peers. On average, 12% of youth and 24% of adults with SB had a medical home. The annual rates of hospital admissions per 1000 persons were 329 for youth and 285 for adults with SB. Rates of admissions were 19.4 and 12.4 times higher, respectively, for these groups than for the general population.
  
  
  CONCLUSIONS
  It appears that persons with SB are accessing health services more often than their age-matched peers, and few have a medical home. We recommend that seamless medical care be provided to all adults with SB, coordinated by a primary care provider, to facilitate comprehensive care.
authors.affiliation: Evaluating Children's Health Outcomes (ECHO) Research Centre, Laurentian University, Sudbury, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. Electronic address: nyoung@laurentian.ca.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Young
authors.affiliation: Evaluating Children's Health Outcomes (ECHO) Research Centre, Laurentian University, Sudbury, ON, Canada.
authors.forename: Lianne A
authors.initials: LA
authors.lastname: Anselmo
authors.affiliation: Evaluating Children's Health Outcomes (ECHO) Research Centre, Laurentian University, Sudbury, ON, Canada.
authors.forename: Tricia A
authors.initials: TA
authors.lastname: Burke
authors.affiliation: Children's Hospital of Eastern Ontario and Ottawa Children's Treatment Centre, Ottawa, ON, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: McCormick
authors.affiliation: Rehabilitation Institute of Chicago, Chicago, IL.
authors.forename: Shubhra
authors.initials: S
authors.lastname: Mukherjee
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D016135:Spinal Dysraphism / Q000628:therapy*
keywords: Adolescent; Health services research; Medical home; Rehabilitation; Spina bifida; Young adult